Generic Name

Ferrous Sulfate

Brand Name

Apo-Ferrous Sulfate (CAN) Feosol, Fer-gen-sol, Fer-In-Sol

Classification Dosage Mode of Action

Iron preparation 325 mg BID Acts to normalize RBC production by binding with hemoglobin or by being oxidized and stored as hemosiderin or aggregated ferrtitin in reticuloendithiliaal cells of the liver, spleen, and bone marrow.

Indication

• • •

Prevention and treatment of iron deficiency anemia Dietary supplement for iron Unlabeled use: supplemental use during epoetin therapy to ensure proper hematologic response to epoetin

Contraindication

Contraindicated with patient with allergy to any ingredient; sulfite allergy; hemochromatosis, hemosiderosis, hemolytic anemias

• Drug Interactions •

Use cautiously with normal iron balance; peptic ulcer, regional enteritis, ulcerative colitis

Drug-drug: Decreased anti-infective response to ciprofloxacin, norfloxacin, ofloxacin; separate doses by at least 2hr • • • • Decreased absorption with antacids, cimetidine Decreased effects of levodopa if taken with iron Increased serum iron levels with chloramphenicol Decreased absorption of levothyroxine; separate doses by at least 2 hr

Drug-food:

Decreased absorption with antacids, eggs, milk, coffee and tea, avoid concurrent administration of any of these

Side/ Effects

Adverse

Side effects: GI upset, nausea, vomiting; diarrhea or constipation; dark or green stools Adverse effects: CNS: CNS toxicity, acidosis, coma and death with overdose GI: Anorexia, diarrhea, dark stools, temporary staining of the teeth

Nursing Responsibility

1. Assess history of allergy to any ingredient, sulfite, hemochromatosis, hemolytic anemias; normal iron balance; peptic ulcer, regional enteritis, ulcerative colitis 2. Assess skin lesions, color, gums, teeth, bowel sounds; CBC, Hgb, Hct, serum ferritin and iron levels 3. Confirm that patient dose have iron deficiency anemia before treatment 4. Give drug with meals if GI discomfort is severe; slowly increase to build up tolerance 5. Administer liquid preparations in water or juice to mask the taste and prevent staining of teeth; have the patient drink solution with a straw

6. Warm patient that stool may be dark or green 7. Arrange for periodic monitoring of Hct and Hgb levels 8. Teach the patient to not take the preparation with anatacids 9. Inform the client that he/she may experience these side effects: GI upset, nausea, vomiting, diarrhea or constipation,dark or green stools 10. Encourage patient to report severe GI upset, lethargy, rapid respirations, constipation

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